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FOR I NSTRUCTI ONS, SEE BACK OF FORMDI SCLOSURE SUMMARYPAGE

COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )Ro n L o n g mu i r f o r S t a t e S e n a t eI MPORTANT: I n d i c a t e b y # t y p e o f c o m m i t t e e y o u a r e r e p o r t i n g f o r . 1 1

I( 1 ) S t a t e w i d e / L e g i s l a t i v e / J u d g e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l C o mm i t t e e ( 5 ) C o u n t y C a n d i d a t e ( 6 ) C i t y . C a N i d a t e ( 7 ) S c h o o l B o a r d o r O t h e rP o l i t i c a l S u b d i v i s i o n C a n d i d a t e ( 8 ) C o u n t y P A C , ( 9 , ) C A y ~ A a ( ' 4 , 0 ) S c h o o l B o a r d o r O t h e r P o l i t i c a lS u b d i v i s i o n PAC ( 1 1 ) L o c a l l

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CANDI DATE COMMI TT EE A ( :C a n d i d a t e Name 1 J F ` P o l i t i c a l P a r t y ( i f a p p l i c a b l e )P o n L o n g mu i r j ; A l ' ~ t R e p u b l i c a nOf f i c e S o u g h t D i s t r i c t ( i f S e n a t e o r H o u s e )

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FOR I NSTRUCTI ONS, SEEBACK OF FORMCOMMI TTEE NAME ( Mu s t b e s a m e a s o n St a t e me n t o f Or g a n i z a t i o n )Ro n L o n g mu i r f o r S t a t e S e n a t e

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DATE RELATI ONSHI P DESCRI PTI ON ESTI MATED J I F FORRECEI VED NAME ANDADDRESS TO CANDI DATE OF I N KI ND F AI R MARKET FUND- RAI SER( MM/ DDNR) OF CONTRI BUTOR " ( i f a p p l i c a b l e ) CONTRI BUTI ON VALUE CONTRI BUTI ON

R e p u b l i c a n P a r t y o f I o wa p o s t a g e 3 , 6 3 3 . 8 4 F-11 0 / 1 8 / 0 4 6 2 1 E a s t 9 t h S t .Des Mo i n e s , I A 5 0 3 0 9I o wa F a r m B u r e a u F e d e r a t i o n PAC m a i l i n g 3 , 1 1 2 . 5 3 EJ1 0 / 2 0 / 0 4 5 4 0 0 U n i v e r s i t y Av e .Des Mo i n e s , I A 5 0 2 6 6 - 5 9 9 7R e p u b l i c a n P a r t y o f I o wa p r i n t i n g a n d r a d i o 2 , 8 5 1 . 6 2 F-11 0 / 2 2 / 0 4 6 2 1 E a s t 9 t h S t . a dDes Mo i n e s , I A 5 0 3 0 9R e p u b l i c a n P a r t y o f I o wa m a i l i n g 3 , 3 8 2 . 4 4 F- 11 0 / 2 2 / 0 4 6 2 1 E a s t 9 t h S t .Des Mo i n e s , I A 5 0 3 0 9R e p u b l i c a n P a r t y o f I o wa p o s t a g e 6 , 3 3 1 . 8 7 E : 11 0 / 2 2 / 0 4 6 2 1 E a s t 9 t h S t .Des Mo i n e s , I A 5 0 3 0 9N a t i o n a l F e d e r a t i o n o f I n d e p e n d e n t l e t t e r s 8 2 . 1 7 F1 0 / 2 6 / 0 4 B u s i n e s s PAC 1 2 0 1 F S t . NW S u i t e 2 0 0Wa s h i n g t o n , DC 2 0 0 0 4 E : 1

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F C, ? I NSTRUCTI ONS, SEEBACK OF FORMDI SCL OSURE SUMMARY PAGECOMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me nt o f O r g a n i z a t i o n )

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~o f t h e l a s t r e p o r t i n g p e r i o d o r mu s t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

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REPORT FOR ( 1 ) ELECTI ON / ( 2 ) NON- EL E CT I ON YEAR .I n d i c a t e b y #

STATEMENT OF CASH ON HANDCASH ON HAND a t t h e b eg i n ni n g o f t h e r e p o r t i n g p e r i o d . ( T o t a l o f a l l f u n ds h e l d b y t h e

c o mmi t t e e . T h i s amo u n t MUST b e t h e s ame a s t h e c a s h o n h a n d a t t h e e n do f t h e l a s t r e p o r t i n g p e r i o d o r mu s t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

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FORI NSTRUCTI ONS, SEE BACK OF FORMCOMMI TT EE NAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i o n )

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FOR I NSTRUCTI ONS, SEE BACKOF FORMDI SCL OSURE SUMMARY PAGECOMMI TTEENAME( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )Ron Longmu i r f o r St a t e Se n a t eI MPORTANT : I n d i c a t e b y # t y p e o f c o mmi t t e e y o u a r e r e p o r t i n g f o r .( 1 ) S t a t e w i d e / L e g i s l a t i v e / J u d g e St a n di n g f o r Re t e n t i o n Ca n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e Pa r t y( 4 ) Co u nt y Ce n t r a l Co mmi t t e e ( 6 ) Co u nt y Ca n d i d a t e ( 6 ) C

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c o mmi t t e e . Th i s amoun t MUSTb e t h e s ame a s t h e c a s h o n h a n d a t t h e e n do f t h e l a s t r e p o r t i n g p e r i o d o r mu s t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADDTOTALMONEYTAKEN I N THI S PERI ODSc h e d u l e A: Cas h Co nt r i b u t i o ns t o t a l ( A t t a ch Sc h e d u l e A) ( ' a l s o s e e i n - k i n d b e l o w) . . . . . . . . . .

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S T A T E C AN D I D AT E S N O T E : I F A C ON T R I B U T I ON I S R E CE I V E D F R O M A S T A T E P A C ( P O L I T I C A L A C T I ON C OM MI T T E E ) , L I S T T H E P A C I D E N T I F I C A T I O NN U MB E R A N D T HE P A C C H E C K N U M B E R I N T H E D ES I G NA T E D C O L U M N A L I S T OF I D N U M B E R S I S A V A I L A B L E F R O M T HE I OWA E T H I C S A N D C A MP A I G ND I S C L O S U RE B O A R DCAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mm i t t e e s

SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECEI PTS

CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESSOF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D # J - u ye t l e CCJCel l b- I t -CC e - e

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FORI NSTRUCTI ONS, SEEBACK OF FORMCOMMI TTEE NAME ( Mu s t b e s a me a s o n S t a t e m e n t dOr g a n a h o n )6 0 1 2 L ~7 S- e S ' &e SCHEDULE( R e v . OMEI N K I NDCONTRI BUTI ONSQCHECK THI S BOX I FAMENDI NG FORMDATERECEI VED( MMMUVYR) NAME AND ADDRESSOF CONTRI BUTOR

RELATI ONSHI PTO CANDI DATE' ( f a p p l i c a b l e )

DESCRI PTI ONOF I N K I NDCONTRI BUTI ONESTI MATEDFAI R MARKETVAL UE

4 I F FORFUND- RAI SERCONTRI BUTI ON

v / ~L r i . t J c t u r n ; ~ u r e c ~ , , ~ F c ' ~ . l C . ^ c : f . i_

5 y f / ~ l . 1 ! n ; ~ e r i ' c y AVL ' ,Wasf Dms1 Y0 r , r~Ls a / y ~ p/ . 7 t 1/ ~ ( .

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FORI NSTRUCTI ONS, SEEBACK OFFORMCOMMI TT EE NAME( Mus t b e sa me a s o n S t a t e me n t o f O r g a n i z a t i o n )/ T o t , J L Ur , , / 1 7 r . L i r ^ ~or ' -s-. cLFe-5017Gl tNOTE : T hi s s c h e du l e r e p o r t s mone y l o a ne d t o t h e c o mmi t t e e wh i c h i s d e p os i t e d i n t h e c o mmi t t e e a c c o u n tTOTAL UNPAI D LOANS FROM LAST REPORTI NG PERI OD $ _

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Z __ _ __ _ __ _ _- - - - - -

PART I - MONET ARY LOANS RECEI VED THI S REPORTI NG PERI OD( O r i g i n a l s o u r c e o f l o a n , s u c h a s a b a n k , mus t b e s h o w n i f a t h i r d p a r t y i si n v o l v e d . I n c l u d e l o a ns f r o m c a n di d a t e ' s p e r s o n a l f u n ds . )

TOTAL ( PART I )

-

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' D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v ema k i n g a c o n t r i b u t i o n t o t h e c o mmi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e g r e e o fc o ns a ng u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y ma r r i a ge ) . I f s u r n a me o f c o n t r i b u t o r i st h e s a me a s c an di d a t e , b ut t h e r e i s n o f a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h er e l a t i o n s h i p c o l u mn w h e n i t a p p l i e s .

PART 1 1 - MONETARY LOAN REPAYMENT S MADE T HI S REPORTI NG PERI OD( L o a n s f o r g i v e n mu s t b e r e p o r t e d o n Sc h ed u l e E - - I n - k i n d C o n t r i b u t i o n s . )

TOTAL CASH REPAYMENT S ( PART l l )F r o m S c he d u l e E - - TOTAL LOANS FORGI VEN

TOTAL OUTSTANDI NGL OANS END OF REPORT PERI OD

Pa g e( f o r S c h e du l e F)

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SCHEDULEF LOANS

( Re v . 0 7 / 0 3 ) RECEI VED& REPAI DCHECK T HI S BOX I FAMENDI NG FORM

DATERECEI VEDMM/ DD/ YR

NAME ANDADDRESSOF LENDER( I n c l u d e En d o r s e r ' s Name, I f A p p l i c a b l e )

RELAT I ONSHI PTO CANDI DATEI f A l i c a b l e *

AMOUNTOF LOAN

DATE PAI D( MM/ DD/ YR)

NAME AND ADDRESS OF LENDER( I n c l u d e En d o r s e r s Name, I f A p p l i c a b l e ) RELAT I ONSHI PTO CANDI DATE'

I f A p p l i c a b l e )AMOUNTREPAI D

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